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Biomedical subjects

J D Frame

Publications and source records attributed to J D Frame.

At least 37 records · Page 2Linked to original sources
PubMed1995

The risk of viral hepatitis A, B, C, and E among North American missionaries.

The seroprevalence and incidence of hepatitis A, B, C, and E virus infection were determined among North American missionaries (n = 328) serving in various geographic locations between 1967 and 1984. The mean age of subjects at entry into the study was 39.7 years (range 5-73 years); 65% were female; 89% had lived outside the United States before the study began. Seventy-eight percent of subjects served in sub-Saharan Africa during the study. At initial evaluation, 50.9% of the subjects had antibodies to hepatitis A virus (total anti-HAV), 8.5% to hepatitis B virus core antigen (total anti-HBc), 0.6% to hepatitis C virus (total anti-HCV by second-generation immunoblot assay), and 0% to hepatitis E virus (IgG anti-HEV). After an average period of service of 7.3 years (2,396 person-years total), 5.8% of the missionaries seroconverted to anti-HAV, 5.5% to anti-HBc, 0.6% to anti-HCV, and 0% to anti-HEV. This study indicates a relatively low risk of hepatitis C and E virus infection among missionaries while confirming the previously reported high risk of hepatitis A and B virus infection. Hepatitis A and B vaccination is recommended for long-term travelers to developing countries.

Adolescent↗
PubMed1994

Facelift surgery: an adjunct in the treatment of capillary malformations (port wine stains).

Hemangiomas and lymphangiomas remain the most common benign tumors seen by the plastic surgeon that involve a neonate's skin and deeper tissues. A significant number of tumors undergo spontaneous regression and require no treatment. The port wine stain (PWS) remains one of the most difficult variants of hemangiomas to treat and continues to be psychologically traumatic throughout a patient's lifetime. Recently, advanced use of laser technology has yielded beneficial results for a significant number of these patients. This report illustrates the incorporation of facelift surgery as an adjunct in the overall management of older patients resulting in decreased use of cosmetics and great improvement in general well being.

Facial Dermatoses↗
PubMed1994

No evidence for chloroquine-associated retinopathy among missionaries on long-term malaria chemoprophylaxis.

Chloroquine continues to have a limited role in the chemoprophylaxis against malaria. Although periodic ophthalmologic examinations are recommended with weekly suppressive dosing, the occurrence of retinopathy associated with this regimen is unproven. Surveillance of career missionaries was conducted to explore the association between total body burden of chloroquine and the development of retinopathy. Five hundred eighty-eight missionaries, reflecting 6,250 person-years of chloroquine exposure were surveyed; 53 persons reflecting 560 person-years exposure with a median cumulative chloroquine dose in excess of 300 g were examined. Only one case of chloroquine-induced retinopathy was detected. This occurred in a missionary who had inappropriately taken chloroquine daily for at least six years as an anti-inflammatory agent for a connective tissue disorder. We also observed that expatriates often overused chloroquine because of apprehension about malaria and used the drug for unrelated conditions. Our results failed to demonstrate an association between a weekly chloroquine dosing regimen and drug-induced retinopathy.

Adult↗
PubMed1993

Skin graft storage and keratinocyte viability.

The viability of human split skin grafts stored in four solutions has been assessed by monitoring the percentage of viable keratinocytes in the stored grafts. Skin grafts stored in RM+ (Ready Mix) tissue culture medium remained more viable than those stored in Hartmann's, Marshall's or saline solutions. By day 10 (postoperative), the percentage of viable keratinocytes of those grafts stored in RM+ was around 85%, compared to a value of around 10% for the other media. By day 30, RM+ achieved a value of around 60% keratinocyte viability compared to a value approaching 1% in the other storage media under investigation. RM+ provides mitogens, nutrients, growth factors and physiological pH, all of which are important factors for successful skin graft storage.

Adolescent↗
PubMed1992

An unusual cause of anuria in a burned child.

When treating children with burns we avoid catheterization whenever possible since the complications may outweigh the benefits. We present the case of a 1-year-old infant with 13 per cent burns who required catheterization. The catheter knotted in the bladder, obstructing urine outflow. A general anaesthetic was required to remove it.

Anuria↗
PubMed1992

Mortality trends of American missionaries in Africa, 1945-1985.

Mortality trends of missionary staff serving in sub-Saharan Africa were tracked for the period 1945-1985. For 1945-1970, when more complete incidence data were available, the missionary death rate was approximately 40% lower, after adjustment, than would be expected in a comparable US population. This trend persisted through 1985. Between 1945 and 1970, the largest number of fatalities was attributable to malignancy, atherosclerosis, accidents, and infectious disease, and the greatest mortality risks, compared with the US experience, were from homicides, the complications of pregnancy, and infections, notably malaria, hepatitis, and polio. Beginning in the late 1950s, motor vehicle accidents became the leading cause of death. Since the 1960s, accidental causes of death have been approximately 50% higher than in the US, and homicides have been four times higher. During this same period, the infectious disease death rate decreased to approximately that within the US. Currently, the leading causes of mortality are motor vehicle accidents, malignancy, and atherosclerosis, followed by other accidental causes, notably aircraft mishaps and drownings. Viral hepatitis is presently the leading infectious disease cause of death. Other contemporary lethal infections include malaria, rabies, typhoid, Lassa fever, and retroviral infection. It was concluded that missionaries in sub-Saharan Africa had a death rate approximately half that expected in a comparable domestic control population. Preventive strategies, particularly relative to accident and infectious disease prevention, could effectively reduce mortality risk further.

Accidents, Traffic↗
PubMed1991

Can protracted relapsing fever resemble Lyme disease?

We report the case of a Protestant missionary who contracted tick-borne relapsing fever in 1979 while serving in the Sudan. Despite tetracycline treatment, his acute illness ran a protracted course, with migratory polyarthralgias lasting approximately 10 months. Symptoms recurred in 1984 and have persisted. At regular intervals, the patient has experienced recurrent episodes of fever, generalized fatigue, bilateral upper and lower extremity muscle weakness, and asymetric large joint polyarthralgia. Indirect fluorescent antibody testing of sera demonstrated titers of 1:16 for B. burgdorferi and 1:64 for B. hermsii, and immunoblotting confirmed past exposure to relapsing fever, but not Lyme disease. It is hypothesized that this individual's chronic symptoms have been related to relapsing fever, and that in certain situations or in select individuals, relapsing fever can be capable of producing a chronic clinical picture analogous to Lyme disease.

Adult↗
PubMed1991

Assessment of risk for HIV-1 infection for missionaries in sub-Saharan Africa.

North American mission boards (N = 82) with programs in sub-Saharan Africa were surveyed to identify practices affecting risk of human immunodeficiency virus type 1 (HIV-1) infection among international staff. Thirty-four percent of participating boards thought risk for HIV-1 infection in missionaries in Africa was greater than it was for the general US population, and 53% considered it greater for overseas medical staff serving in the region than for domestic health care workers. Nevertheless, only 24% of boards had formal AIDS education programs for overseas health care workers, and 19% for nonmedical personnel going abroad. Medical care provision and acquisition were considered high-risk activities; 42% of boards with a known policy acknowledged that disposable injection equipment was routinely reused, 68% indicated that immunizations were provided abroad, and 60% admitted that inoculations were administered by indigenous health care workers. The most frequently cited specific suggestion for decreasing the risk of HIV-1 infection overseas was the implementation of a walking blood bank program. We conclude that current practices and logistic constraints make HIV-1 transmission possible. Risk reduction strategies include more comprehensive health education programs, greater adherence to universal precautions, less dependence on the indigenous Third World health care system, and implementation of innovative programs for health care delivery.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Acute ischaemia of the hand following accidental radial artery infusion of Depo-Medrone.

Acute ischaemia of the hand following the accidental intra-arterial injection of steroid has not, to our knowledge, been previously reported. We present such a case of the injection of Depo-Medrone with Lidocaine (Upjohn) into the right radial artery during attempted treatment of stenosing tenosynovitis of the right thumb. The resultant acute ischaemia was successfully managed after 20 hours by a combination of surgical thrombectomy, intra-arterial streptokinase and intravenous heparin and thymoxamine.

Acute Disease↗